Age, Gender, Geographic and Clinical Differences for Gallstone and Its Subtypes in China: A Nationwide Study Among Approximately 11 Million Adults

Abstract

Background:There is no comprehensive nationwide study on the prevalence of gallstone and its risk factors in China. Methods:We used the data set from preventive health screening centers covering all provinces in mainland China except for Tibet, and a total of 10,937,993 adults were included, who received abdominal ultrasonography from January 1st to December 31st, 2017. Gallstone was categorized into gallbladder (GB) stones, intrahepatic bile duct (IHD) stones, and extrahepatic bile duct (EHD) stones. The prevalence of gallstone and its different subtypes, as well as their risk factors were investigated. Findings:The nationwide age-standardized and gender-standardized prevalence (ASGS-prevalence) of gallstone diseases in 2017 was 5.13% (95% CI: 5.11%-5.14%). GB stones accounted for 76.3% of all gallstone cases, followed by IHD (24.3%) and EHD (0.2%). The age standardized prevalence was higher in women than that in men (5.41% vs 4.85%, p 1). Interpretation:The gallstone disease was highly prevalent in China. The prevalence largely varied by disease subtype, demographic factors, geographic location and metabolic factors. Public health strategies preventing gallstones should be region-specific and target on the distinct risk factors of different gallstone subtypes. Funding Statement: This research was funded by International Science and Technology Cooperation Projects (2016YFE0107100 and 2015DFA30650), CAMS Clinical and Translational Medicine Research Funds (2019XK320006), CAMS Innovation Fund for Medical Science (CIFMS) (2017-I2M-4-003 and 2018-I2M-3-001), Capital Special Research Project for Health Development (2014-2-4012), Beijing Natural Science Foundation (L172055 and 7192158), the Fundamental Research Funds for the Central Universities (3332018032), the National Undergraduates Innovation and Training Program of Peking Union Medical College (2019zlgc0652), and National Ten-thousand Talent Program. Declaration of Interests: There is no conflict of interest to declare. Ethics Approval Statement: This study was reviewed and approved by the Institutional Review Board of Peking University (PU IRB).